Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods.

BACKGROUND: Early entry into nonparental care (NPC) and introduction to solid foods (ITS) have been linked to elevated weight, however, little research exists on the combined influence of these transitions on child weight over time. OBJECTIVES: Identify groups of children based on early NPC and ITS timing and examine whether NPC-ITS groups differentially affect child weight over time. METHOD: Data were drawn from STRONG Kids2 (n = 468). Primary predictors include NPC (by 3M)-ITS (< or ≥6M) groups; outcome variables include child weight-for-length/height z-scores (WFL/WFHz) (3, 12, 18, and 24 months). Multilevel regression was used to examine the NPC-ITS groups as predictors of child WFL/WFHz. RESULTS: Six groups were identified: 27% Parental Care-ITS before 6M, 31% Parental Care-ITS after 6M, 12% Daycare-ITS before 6M, 14% Daycare-ITS after 6M, 10% Kincare-ITS before 6M, and 7% Kincare-ITS after 6M. Children who were in daycare (regardless of ITS) or kincare-ITS before 6M demonstrated the highest WFL/WFHz over time, compared to their parental care counterparts. CONCLUSIONS: NPC-ITS combinations on child WFL/WFHz across the first 2 years of life highlight the need for a partnership approach among parental and nonparental caregivers to support the feeding of infants throughout the transition to solid foods.

Father support for breastfeeding mothers who plan to utilize childcare: A qualitative look at Mothers' perspectives.

Breastfeeding exerts many health benefits for the infant and the benefit is affected by exclusivity and duration, however, most mothers in the U.S. breastfeed for a shorter duration than recommended. First-time mothers who return to work outside the home, utilize childcare, and pump to continue to provide human milk, all of which have been found to reduce breastfeeding duration individually, represent a subset of breastfeeding mothers facing several known barriers to breastfeeding continuation and at risk for early breastfeeding cessation. The aim of this study is to understand and describe the perceptions of first-time mothers with prenatal intentions to breastfeed and utilize childcare, of paternal support for the breastfeeding experience. A semi-structured interview guided data collection with 24 first-time breastfeeding mothers and responses were analyzed using thematic analysis. Two main themes from mothers' experiences highlight the perceptions of first-time mothers, who had prenatal intentions to breastfeed and utilize childcare, were shaped by the actions, behaviors, and beliefs of their partners throughout the breastfeeding process, as well as illustrate both mothers and fathers lack knowledge of how to optimally involve fathers in breastfeeding. Our findings extend evidence for two existing models of father support to promote breastfeeding as relevant to mothers who return to work outside the home and utilize childcare, and additionally identify an area of support not included in either model. Early and improved education that situates breastfeeding within the co-parenting relationship and includes paternal support for pumping has the potential to improve mothers' breastfeeding experience and breastfeeding duration through mothers' return to work and infants' transition to childcare.

An Exploratory Look at the Role of Childcare Providers as a Support and Resource for Breastfeeding Mothers.

Introduction: The childcare setting remains largely unexplored as a potential barrier to breastfeeding continuation and, therefore, the lack of interventions targeting childcare providers may be a missed opportunity for improved breastfeeding support. This article explores the perceptions of 25 first-time breastfeeding mothers on navigating the critical transition to childcare and the role of childcare providers regarding breastfeeding support. Methods: Mothers were selected if they indicated an intent to breastfeed on a prenatal questionnaire and had enrolled their child in childcare. Semistructured interviews guided by Bronfenbrenner's bioecological model were conducted to capture mothers' experiences. Responses were analyzed utilizing thematic analysis to generate themes rooted in mothers' experiences with childcare and breastfeeding. Results: A thematic analysis resulted in three key themes: Providers are not Critically Evaluated, A Stressful Transition, and Childcare as a Service, not Support. These themes indicated that although mothers intended to continue breastfeeding during and after the transition to childcare, they had not previously given much consideration to the childcare setting beyond that of a service provider. Conclusion: Findings illustrate new considerations to support modern breastfeeding mothers through the transition to work and childcare are needed such as basic and practical education and training to prepare childcare providers to support breastfeeding mothers in the way that best meets their needs, enhanced education for mothers on how to seek and evaluate providers for breastfeeding competence, and policy initiatives focused on fostering engagement between mothers and providers. By taking mothers' perceptions into consideration, researchers, practitioners, and policymakers can offer breastfeeding support that mothers will be receptive to and more likely to engage with, thereby advancing the health of both mothers and infants.

Sources of Information and Support for Breastfeeding: Alignment with Centers for Disease Control and Prevention Strategies.

BACKGROUND AND OBJECTIVES: Research consistently supports health benefits of breastfeeding; however, rates in the United States remain below Healthy People 2020 goals. To increase breastfeeding, information and support are needed from multiple sources. Given differences in breastfeeding rates by demographic characteristics, sources of information and support may also differ. In addition, recent research suggests potential differences in health outcomes related to feeding method (direct breastfeeding only, feeding expressed human milk, combination-feeding with formula). This study examined (1) information and support received within Centers for Disease Control and Prevention (CDC)-defined strategies for supporting breastfeeding mothers, (2) differences in rates of information and support received by demographics, and (3) associations with feeding method at 6 weeks postpartum. MATERIALS AND METHODS: A sample of 447 women participating in the Synergistic Theory Research Obesity and Nutrition Group (STRONG) Kids 2 study completed surveys with questions from the CDC Survey on Infant Feeding Practices II related to sources of information and support for breastfeeding and breast pump use, and about demographics and feeding method at 6 weeks postpartum. RESULTS: Frequencies of supports received within each category indicate that professional supports were the most pervasive, followed by support from friends and relatives. However, women at greater risk for breastfeeding cessation (lower education, Women, Infants, and Children participants, single mothers) received information and support at lower rates. Education and information support was the only source significantly associated with feeding method. CONCLUSION: New approaches are needed to increase efficacy of information delivery, especially for at-risk populations, to better meet CDC recommendations.